The ‘compassion without compulsion’ Obamacare fix

Last night, I received an email from President Barack Obama about his health law. He said, “The law is working. Already nearly 365,000 people across the country have picked private plans through the Marketplace.”

Sorry, Mr. President, but a mere 365,000 people signing up on the federal health exchange, while almost 50 million are uninsured, proves the law is not working. Even the 365,000 number is phony. Only a quarter of those people took the final step and paid, the difference between window-shopping and actually getting insured.

Compare that with over 5 million victims of Obamacare who have had their plans canceled, as well as 200,000 people with preexisting conditions who will lose their coverage in state high-risk pools when they close in the coming weeks because of Obamacare. These people don’t have to be sold on the idea of having health insurance. They previously had it and desperately wanted to remain insured.

But the malfunctioning healthcare.gov website — plus premium sticker shock — and the realization that most exchange plans don’t allow access to specialists, academic hospitals and expensive medications people with health problems need have deterred these people from signing up.

Last week, the administration announced rules that bully insurers into retroactively covering people who pay late or only partially pay their premium. Insurers were warned that if they don’t cooperate, they could be barred from the exchange next year.

This Chicago-style arm-twisting is just the latest of many illegal changes the president has made to the law. Obamacare barely resembles the Affordable Care Act passed in 2010. Obama has put aside the employer mandate to force more people onto the exchanges, scuttled income verification for subsidy recipients and so on. All are in violation of our nation’s bedrock principle — the rule of the law.

The federal government has spent over $6 billion on federal and state exchanges, including over $600 million for the dysfunctional federal website. It’s spent money for computers, community organizations, navigators and slick ads, not for bandages and bedside care. What a waste! The tale is wagging the dog.

It’s time to get rid of the exchanges.

When Congress returns after its New Year’s recess, it should act immediately. The votes are unable to repeal Obamacare, but that doesn’t mean the law can’t be fixed for the near term to prevent more people from losing their coverage.

Here’s a roadmap for a “compassion without compulsion” compromise.

—Keep the provision that allows adult children to stay on a parent’s plan until age 26. It’s a cost-hiker but popular.

—Keep the Medicaid expansion, in which the neediest are helped. States have the option to expand or not.

—Provide block grants to states to expand high-risk pools. That will rescue 200,000 people about to lose coverage and 1.8 million who were on wait lists. Cost: $11,000 per person or $22 billion a year.

—Bring back temporary federal subsidies to help the unemployed pay for COBRA premiums until they regain on-the-job coverage. This is aimed at the industrious who lose coverage because of a job loss. As many as half regain on-the-job coverage within a year, according to the Congressional Budget Office. Cost: $2 billion a year, based on past experience.

—Pay for block grants and COBRA subsidies by eliminating exchange subsidies, which are budgeted to cost $26 billion the first year. Obamacare makes households with $92,000 in income eligible for exchange subsidies. That’s an outrage. The money should be targeted to help people with preexisting conditions or those who have lost their jobs.

—Eliminate the “Washington Knows Best” requirement that all health plans have to cover “essential benefits.” This caused plans in the individual market to be canceled and it’s making exchange plans unaffordable. Don’t force the 50-year-old woman to pay for maternity care.

—Eventually Republicans may have the votes for medical liability reform, across-state-lines insurance sales and health savings accounts, which are all cost-reducing strategies.